What Happens to Your Prescription When the Pain Gets Treated

Your opioid prescription is not simply taken away when you come here for pain treatment. Find the structure causing the pain and treat it directly. Then the need for the medicine falls, at a pace you can handle and with a plan.

If you take opioid pain medicine and you are coming to a pain clinic, one question usually sits under the visit: are they going to take it away from me?

The honest answer is that the dose is not what we are treating. What happens to your prescription depends on what happens to the pain. Those are two different clocks.

Why a taper on its own is not the plan

Lowering a dose is a treatment step with its own risks, and those risks have been measured. One study looked at 113,618 adults on steady, higher-dose opioid therapy. Periods after a taper had 9.3 overdose or withdrawal events per 100 person-years, compared with 5.5 in periods without one. They had 7.6 mental health crisis events, compared with 3.3. The faster the drop, the higher both rates. A second analysis of the same group found the higher risk still there into the second year.

That is why nobody here will lower your dose faster than you can handle, or leave you mid-taper without a plan. It is also why a taper is not treated as a win in itself. Our full position is on the opioid stewardship page.

The route that actually lowers the requirement

There is a second reason a dose comes down, and it is the one worth aiming at. Long-term opioid use can make the nervous system more sensitive to pain, not less. This is called opioid-induced hyperalgesia. When that is happening, raising the dose buys a short gain and then a worse starting point. The pain often spreads past where it started. One review calls more opioid prescribing in that case largely futile.

The useful part is that this can run in reverse. Reviews of opioid tolerance and hyperalgesia note that interventional techniques (procedures that lower the pain signal itself) can let the dose come down. In doing so, they can unwind what drove the dose up. Find the structure causing the pain and treat it directly. Then the need for the medicine falls on its own, instead of being taken away from you.

That is what the diagnostic work at the start of your visit is for. It is also why medication management here sits alongside procedures, not in place of them.

What that has looked like

On International Overdose Awareness Day in August 2026, Dr. Gurpreet Singh Padda, MD, MBA, MHP published the opioid figures from his interventional practice:

• New patients arrive on an average of more than 90 morphine milligram equivalents a day, after more than two and a half years in pain.
• Within 90 days of active interventional treatment, 21% are completely off opioid pain medication.
• Within one year, 34% are completely off all opioid pain medication.
• Of those who cannot be fully weaned, most are brought below 30 MME a day.

Those are practice-reported figures from that patient population, not trial outcomes, and individual results vary — yours will depend on what is causing your pain and what can be done about it. The release was carried by AP News; the full announcement is here.

What to expect at the first visit

• You will not be discharged for arriving on an opioid prescription. Most patients do.
• You will be asked to use one prescriber and one pharmacy. The prescription monitoring program is checked for every patient. It is not an accusation.
• The first work is diagnostic — finding which structure is causing the pain before anything is treated.
• If a dose comes down, it comes down because something changed. It comes down at a pace you can handle, with a way back if it does not go well.

About Dr. Gurpreet Singh Padda, MD, MBA, MHP.

Sources

• Agnoli A, Xing G, Tancredi DJ, Magnan E, Jerant A, Fenton JJ. Association of dose tapering with overdose or mental health crisis among patients prescribed long-term opioids. JAMA. 2021;326(5):411–419. PMID 34342618 · DOI 10.1001/jama.2021.11013.
• Fenton JJ, Magnan E, Tseregounis IE, Xing G, Agnoli AL, Tancredi DJ. Long-term risk of overdose or mental health crisis after opioid dose tapering. JAMA Network Open. 2022;5(6):e2216726. PMID 35696163 · DOI 10.1001/jamanetworkopen.2022.16726.
• Mercadante S, Arcuri E, Santoni A. Opioid-induced tolerance and hyperalgesia. CNS Drugs. 2019;33(10):943–955. PMID 31578704 · DOI 10.1007/s40263-019-00660-0.
• Colvin LA, Bull F, Hales TG. Perioperative opioid analgesia — when is enough too much? A review of opioid-induced tolerance and hyperalgesia. The Lancet. 2019;393(10180):1558–1568. PMID 30983591 · DOI 10.1016/S0140-6736(19)30430-1.
• Lee M, Silverman SM, Hansen H, Patel VB, Manchikanti L. A comprehensive review of opioid-induced hyperalgesia. Pain Physician. 2011;14(2):145–161. PMID 21412369.